NPIMap

Organization Active NPI

Community Health Association

Doing business as Jackson General Hospital

  • Critical Access Hospital
  • Ripley, WV
National Provider Identifier
1649277476
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
52 Issued in WV
Legal business name
COMMUNITY HEALTH ASSOCIATION
Doing business as
Jackson General Hospital
Practice address
122 Pinnell Street
Ripley, WV 25271-0720
Phone
(304) 373-1477
Fax
(304) 372-2749
NPI assigned
Jul 7, 2005
Last updated
Oct 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Stephanie L McCoy
Title
President Ceo
Phone
(304) 373-1475

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 52 WV
Critical Access Hospital 282NC0060X 52 WV Primary

Addresses

Primary practice location

122 Pinnell Street
Ripley, WV 25271-0720

Mailing address

PO Box 720
122 Pinnell Street
Ripley, WV 25271-0720
Phone (304) 373-1477

Other identifiers 6

IdentifierTypeStateIssuer
51-Z320OtherWVSWING BED
5100181OtherWVMEDICARE- ID
51U018OtherWVSWING BED
3910000963MedicaidWV
512320OtherWVSWING BED
3810023822MedicaidWV

Other names 1

  • Jackson General Hospital Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH
CONNECT URL https://www.mettles.com Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031219000784 WV Part B Supplier - Clinic/Group Practice 1759291313 Receives reassigned benefits from 135 practitioners
6 other NPIs on this enrollment
Practice locations: Ripley, WV; Ravenswood, WV
O20160525000610 WV Part A Provider - Critical Access Hospital 1759291313 Receives reassigned benefits from 124 practitioners
1 other NPI on this enrollment
Practice locations: Ripley, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649277476. Details of each certification follow.

Hospital certification: CCN 511320

Legal name
COMMUNITY HEALTH ASSOCIATION
Doing business as
JACKSON GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Oct 1, 2012
Last certification
Jan 31, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationProprietary
Incorporated
Jul 1, 1966 in WV
Enrollment address
122 Pinnell St
Ripley, WV 25271-9101
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Jackson General HospitalCCN 511320 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

504 Washington St
Ravenswood, WV 26164
Phone (304) 373-1476

186 Pinnell St
Ripley, WV 25271
Phone (304) 373-1546

1105 9th St
Vienna, WV 26105
Phone (304) 295-4525

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sarah Brown Individual Corporate Director May 27, 2014
Frederick W Parsons Individual Corporate Director May 27, 2014
John Gorrell Individual Corporate Director May 23, 2006
Carl Westfall Individual Corporate Director Mar 1, 2017
Rodney Felty Individual Corporate Director Apr 28, 2020
Donald Keith Rake Individual Corporate Director Mar 25, 2003
Deborah Burge Individual W-2 Managing EmployeeMGR ENT Patient Fin SVCS Jun 1, 2021
Michael Ritchie Individual Corporate Director Mar 22, 2011
Carl L Overmiller Individual Corporate DirectorBoard Member Oct 1, 2020
Jamion Wolford Individual Corporate Director Mar 1, 2016
James Hunter Individual Corporate Director Mar 28, 2006
West Virginia United Health System, Inc Organization, Morgantown, WV Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2022 100%
Candace Miller Individual Other Jul 15, 2024
Veronica Lewis Individual Corporate DirectorBoard Member Apr 20, 2022
William Smith Individual Other Jun 10, 2024
Carolyn Rader Individual Corporate Director Mar 1, 2017
James T. Hughes Individual Corporate Director Mar 27, 2001
Brenda G Greene Individual W-2 Managing Employee Jan 3, 2011
Robert Fisher Individual Corporate Director Mar 23, 2004
Carroll Lee Corder Individual Corporate Director Jan 3, 2011
Michael Casdorph Individual Corporate Director Oct 24, 2018
West Virginia University Hospitals Inc Organization, Morgantown, WV Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2022 100%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 52

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 52

Practitioners & affiliated clinicians

Practitioners 139

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 139

Affiliated clinicians 225

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 225

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1649277476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720",
            "address_2": "122 PINNELL STREET",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252710720",
            "telephone_number": "304-373-1477",
            "fax_number": "304-372-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 PINNELL STREET",
            "city": "RIPLEY",
            "state": "WV",
            "postal_code": "252710720",
            "telephone_number": "304-373-1477",
            "fax_number": "304-372-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "304-373-1475",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "WV",
            "license": "52",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WV",
            "license": "52",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWING BED",
            "identifier": "51-Z320",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE- ID",
            "identifier": "5100181",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWING BED",
            "identifier": "51U018",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3910000963",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWING BED",
            "identifier": "512320",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023822",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Parkway",
            "address_2": "Suite 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "21044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Jackson General Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson General Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ripley, WV

Sources for this page

Verify at the official NPI Registry.